Postoperative outcome of early oral feeding following elective colonic anastomosis

To assess the safety of early oral feeding after colonic anastomosis. Descriptive case series. Department of Surgrey Lady Reading Hospital Peshawar, from September 2009 to April 2011. Preoperative evaluation included history, physical examination and base line investigations. A limited bowel preparation was done in all the patients. Postoperatively 10-60 ml of sips were allowed 3 hourly after recovery from anesthesia. Free oral fluid intake was allowed on postoperative day-1, semisolids on day-2 and 3 as tolerated and full oral diet allowed on day-4. In case of two episodes of vomiting and absence of bowel sounds, patients were kept nil by mouth and nasogastric tube was placed. Out of total 101 patients, 77 [76.24%] were males and 24 [13.76%] females [M:F 3.2:1]. The age range was from 25 year to 77 year with mean age of 49.5 +/- 2.3 year. The time of passge of first flatus was 2 to 6 days [mean 2.4 days], and the time of first passage of stool was 4-9 days [mean 4.6 days]. Twenty two [21.78%] patients did not tolerate feeding. They developed vomiting and abdominal distension. Postoperative complications included wound infection [7.92%], electrolyte imbalance [4.95%], respiratory tract infection and aspiration pneumonia [5.94%], anastomotic leaks [0.99%] and wound dehiscence [1.98%]. The hospital stay was 3-8 days [mean 5.4 days]. Early oral feeding after colonic surgery was safe and well tolerated by majority of the patients